“I’m happy to tell you the surgery went quite well, so you’re going to be on the mend! Obviously, you’re going to have some pain from this, so what I’ll just do is ruin your life, happiness, and relationships by giving you an opiate. Sound good? So… you’ll start off taking it according to these directions I’m jotting until, of course, your brain’s addictive wiring trumps your reason – haha, just like the old days! – and you find yourself helplessly abusing it. Eventually, I’d like to see you transition to your drug of choice. When you do that is up to you, but within a couple months, you should find yourself back in full-on relapse. Okay? Does that sound good? I’ll just call it in now.”

If only doctors actually said this, we alcoholic-addicts might have a better chance of protecting our sobriety from the pain management substances that work fine for normies (i.e. non-addictive people). The trouble is that, even today, the vast majority of doctors don’t get recovery. They see before them a reasonable and sane person who, they assume, will self-administer a prescribed drug reasonably and sanely.

What they don’t get is that we’re different. Our brains are forever like a duplex we share with an insatiable lunatic who is temporarily napping. Rap on its door with an opiate and – no matter how intently we self-manage the dosage – once that beast wakes up, all bets are off. It’ll rage, it’ll bust shit up, it’ll burn the whole damn house down, motherfucker. Because that beast has a hold on us more powerful than anything that well-meaning doctor can possibly imagine.

It’s more powerful than reason, than resolve, than all things human. It’s run our lives before, and it’s psyched to do it again.

I remember the first time I raised my voice at a medical authority – my very kind dentist, a British woman – when I was about four years sober. She’d just extracted one of my molars, and I’d just declined pain meds. I remember the room we were in when she insisted, because it seemed to shrink and turn more yellow and seal off every doorway connecting me to AA. I could feel the excitement rise in my chest: Meds! Something GOOD! There was hope! Something really delightful perched just on the horizon! Sure, I’d take ’em sensibly! Of course!

…And I can’t say where it came from, but that small counter-voice, that love for the gift of sobriety and all the goodness it nurtured in my life – that sprang up in me, too. They fought. So by the time the words came out my mouth, sloppy from novocain, they were way too loud, too urgent, and too emotional.

“No! I told you, I’m an alcoholic!”

“Yes, I know. But this is a very safe drug – Vicodin. You’ll be fine.”

“No, I won’t! I’m sober and I want to stay that way!”

I remember the look of distaste on her face, that this normally calm and socially appropriate patient was going off on her. She tried again, emphasizing the small dosage, but by that point tears spilled from my eyes and I had just one tremulous, throaty word for her: Ibuprofen. Ibuprofen. I’ll take ibuprofen…

And I did. End of anecdote.

I’m not blaming doctors. They’re rational; it’s we who make no sense! That’s why the onus is on us to keep out of our lives what docs assure us is safe. They don’t getthe “curious mental blank spot.” They haven’t heard the heart-rending shares of misery, helplessness, and loss sometimes dragging on for years – all triggered by a sensible prescription. I have a huge number of friends in recovery. And in contrast to the one alcoholic I know who successfully manages back pain with meds her partner doles out, I know at least a dozen who have relapsed catastrophically – not counting those who have died.

I was Facebook messaging with one of them yesterday. He’s a wonderful guy traveling the country, working odd jobs, and trying to stay off heroin for more than a few months at a time. But failing. He had a week. Here’s what he messaged:

“Yah know, if I’d of known what I would become after a few Vicodin, I’d a shoved them up my doctor’s ass!! I was never into opiates as a kid. But eight years into sobriety I hurt myself really really bad, and I guess I needed them. But in hindsight, if I had a choice between acute pain and becoming a heroin addict, I would have probably chose the pain. But whatever. It’s done. It’s over, right?”

Maybe. Maybe not.**

When we want to drink or use, only god can help us. But when someone else tells us it’s not a problem, we can use our brains. Remember: the doctor is going to offer you something so legitimate, so routine, so neat! The prospect of those little pills fucking up your life will seem so overly dramatic! What I do is this: I picture a set of balance scales with two big pans. On one side I put the prospect of perturbing my doctor, making a stink, sounding like an uncooperative bitch, no one getting it, and, quite likely, some physical pain. On the other side I put every blessing I’ve won back sober, every person I love, every friend who needs me, my self-respect, my inner dignity, my body’s health, my spirit’s channel to god – and every beauty and joy of this life.

Then I bite my tongue to keep from saying, “Don’t you dare fuck with my sobriety!” But it’s right there – that sense of defending what I love.

If your pain is such that you’ve absolutely got to take some meds, agree to a prescription of five pills. Maybe eight. Then call someone for each goddam pill you take and say, “It is 4:00, and I am taking a percocet now.” Draw up a chart to keep exact track of what time you dosed, whom you called, and whom you’re calling next. Stay in touch with your sponsor. And as soon as you can, switch to ibuprofen and get the pills out of your house. Do nothing alone because – remember – you’re not really alone: there’s that slumbering beast in the duplex, and you’re making a racket.

I recall the sadness I felt post-surgery many years ago, flushing the three remaining Vicodin I’d been given. The magic was gone. Now there was just me… and my stupid old life. It took about five minutes for gratitude to return: the vial was empty, but my future was full. I was sober.

Thanks, Abbie! What an excellent write-up of tips specific to surgery! We overlap a lot, and I sooooooo agree with the pointers you offer about being sure everyone on your surgery team knows you’re in recovery (I’ve had one super compassionate anesthesiologist whose best med school buddy had just been barred for using his own stuff, and one who really didn’t give a rat’s ass), asking for help, and watching out for depression from loneliness – all are absolutely. right. on.

I had a lengthy surgery on my ankle 6 yrs. ago. I did tell my surgeon that I was in recovery & wanted to stay there. He was sympathetic, but I still went home with narcotics. Thank God I was 17 yrs. sober at the time & had told everyone close to me that this whole scenario was about to play out. I went home with Percocet. When it was time to take a pain killer I talked it over with my Higher Power, took the medicine & very carefully wrote down the time & dosage on a pad. I never, ever took it even one minute ahead of the time it was due & discarded nearly half the bottle in a short time. I am extremely careful about that kind of thing. I am still sober & now facing a major surgery once again. My HP, I know, will protect me again as long as I am diligent.
Carol L

Way to stay clean and sober, Carol! It’s very true that in the case of surgery, ibuprofen is *not* an option because of its blood-thinning side-effect, so we pretty much HAVE to take narcotics (even Tylenol 3 contains codeine – a narcotic). Having a thorough plan like yours (or Abbie’s, above) can make all the difference. In your case, just having all your close friends know what was up, in addition to your HP connection, was enough to keep you on track. Other people need a companion RIGHT THERE in their homes. Whatever works. 🙂

good article. But —
It’s easy to use the used words in this article, just rather unpleasant when getting information on “the high road” and indicative of a lack of vocabulary/adjectives. Also, G-O-D is spelled with a capital lette.

Thanks, Eleanor, but I LOVE swearin’ and always will. I consider well-placed cuss words analogous to spices in food: they’re no substitute for nutrition, but they sure add zest! And of course, in writing of your God you may feel that following the convention of capitalization connotes respect. But I’m talking about my god – which fuckin’ LOVES my cussin’ and doesn’t give a rats ass about caps. 🙂

Hi… Great posts. Came across by accident (not). Had heart attack 2 days before Christmas. Somewhere in there pulled muscle in chest cavity. In hospital put on dilatin, morphine. Blah blah. Did I mention I am a recovering narcotics addict.? Left hospital with OxyContin, Xanax and inability to take a breath due to muscle pulls. Have a active 25 year old son. Never saw him during whole ordeal. That was mind boggling to me. Not sure why. His father found dead from overdose 8 years ago. Did I mention I’ve been in al anon for 20 years. Did I mention been clean for 32 years. Out of work for awhile, disconnected, The gorilla talks 24/7. Oxy’s r gone still have Xanax. I’m sure I’ll take them till gone. I,m a card carrying member of the
Empty vile club. Who’s terms am I living life on; dr’s, mine, or God’s?
.

Wow, Linda – you’ve been through so much! Try to take good care of yourself. I’ve never had Xanax, but I’ve heard stories… Be careful of that stuff! Reach out. Your chosen family can take the place of your blood family, but only if you ASK for support. With 32 years, you know all this, but I’m just chiming in with your anti-gorilla voices, saying reach out to fellows in recovery and your HP! I’ll be thinking of / praying for you.